PINE REST CHRISTIAN MENTAL HEALTH SERVICES (NPI# 1386015683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386015683 |
| Entity Type | Organization |
| Organization Name | PINE REST CHRISTIAN MENTAL HEALTH SERVICES |
| Practice Address |
300 68th St Se Grand Rapids MI 49548-6927 |
| Practice Telephone | 6162816372 |
| Practice Fax Number | 6162816459 |
| Mailing Telephone | 6162816372 |
| Mailing Fax Number | 6162816459 |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2020-11-04 |
| Authorized Official Name | DIANE FENNEMA (MANAGED CARE ADMINISTRATOR) |
| Authorized Official Telephone | 6162816372 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154339521 | Pine Rest Christian Mental Health Services | Psychologist | 550 - 3 Mile Rd Nw, Grand Rapids, MI 49544-1673 | 2006-08-03 |
| 1841791357 | Pine Rest Christian Mental Health Services | Substance Abuse Rehabilitation Facility | 300 68th Street Se, Grand Rapids, MI 49548 | 2018-02-21 |
| 1952818551 | Pine Rest Christian Mental Health Services | Substance Abuse Rehabilitation Facility | 450 Meadow Run Dr, Hastings, MI 49058-9053 | 2018-01-04 |
| 1619341310 | Pine Rest Christian Mental Health Services | Counselor | 9090 S Rodgers Ct Se, Caledonia, MI 49316-8052 | 2015-11-18 |
| 1598138810 | Pine Rest Christian Mental Health Services | Counselor | 1870 Leonard St Ne, Grand Rapids, MI 49505-5650 | 2015-11-09 |
| 1467840553 | Pine Rest Christian Mental Health Services | Nurse Practitioner | 17325 Van Wagoner Rd, Spring Lake, MI 49456-9702 | 2014-12-26 |
| 1821414566 | Pine Rest Christian Mental Health Services | Counselor | 1350 W Centre Ave, Portage, MI 49024-5361 | 2014-03-05 |
| 1467873414 | Pine Rest Christian Mental Health Services | Speech-Language Pathologist | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2013-12-18 |
| 1427216241 | Pine Rest Christian Mental Health Services | Counselor | 4294 Laurel Dr, Lake Odessa, MI 48849-9423 | 2008-05-29 |
| 1487837506 | Pine Rest Christian Mental Health Services | Psychiatry & Neurology | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2007-12-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PINE REST CHRISTIAN MENTAL HEALTH SERVICES | 300 68th St Se, Grand Rapids, MI 49548-6927 |
| Iowa Business Entities | PINE REST CHRISTIAN MENTAL HEALTH SERVICES | 300 68th St Se, Grand Rapids, MI 49548 |
| Street Address |
300 68TH ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49548-6927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114920550 | Emergency Physicians Inc PC | General Practice | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2005-05-31 |
| 1235742768 | Robert Milton Hughes | Physician Assistant | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-08-25 |
| 1992317580 | Jacob Alan Lowe | Psychologist | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-08-17 |
| 1922619063 | Jennifer Nicole Oconnor | Social Worker | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-08-12 |
| 1407464670 | Christina Joy Weaver | Physician Assistant | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-07-14 |
| 1780200436 | Wendy Forrest | Psychiatry & Neurology | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-06-18 |
| 1003430877 | Cory Manoogian | Psychiatry & Neurology | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-06-08 |
| 1992329650 | Amy Joy Smith | Psychologist | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-05-29 |
| 1134743800 | Brendan Mcneilly | Psychiatry & Neurology | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-05-29 |
| 1467075176 | Luke Vander Wal | Psychologist | 300 68th St Se, Grand Rapids, MI 49548-6927 | 2020-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205319811 | Pooja Patel | Social Worker | Spectrum Community Services, 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2018-09-10 |
| 1063906865 | Kimberly Eccher | Physician Assistant | 300 68th St. Se, Grand Rapids, MI 49548 | 2018-06-15 |
| 1871099481 | Baymark of Michigan, Inc. | Clinic/Center | 5500 Division Avenue Se, Kentwood, MI 49548 | 2018-04-03 |
| 1629507801 | Laura Marie Quennoz | Psychiatry & Neurology | Pine Rest Christian Mental Health Services, 300 68th Street Se, Grand Rapids, MI 49548 | 2017-06-09 |
| 1821548504 | Alison Anderson | Technician, Other | 103 Roth St Se, Grand Rapids, MI 49548 | 2016-10-06 |
| 1831540152 | Jesse Aubil | Counselor | 264 Montebello St. Se 49548, Grand Rapids, MI 49548 | 2016-06-28 |
| 1306237920 | Sarah Benton | Social Worker | 225 Colrain St Sw, 2, Grand Rapids, MI 49548 | 2015-02-18 |
| 1578996856 | Karen Marie Irving | Social Worker | 3353 Lousma Dr. Se, Wyoming, MI 49548 | 2013-08-09 |
| 1740348044 | Robert Kenneth Richmond | Preventive Medicine | 551 36th Street. Se, Wyoming, MI 49548 | 2006-12-05 |
| 1386738953 | Sharita Montiez Hall | Social Worker | 300 68th Street Se, Grand Rapids, MI 49548 | 2006-10-03 |
| Find all providers in zip 49548 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020558 | Danita Mcalister | Counselor | 2504 Normandy Dr Se Apt 213b, Grand Rapids, MI 49506-7901 | 2020-10-16 |
| 1013521574 | Megan Flier | Counselor | 3744 Bradford St Ne, Grand Rapids, MI 49525-3325 | 2020-09-02 |
| 1457962078 | Cappon Consulting LLC | Counselor | 1344 Mayfield Ave Ne, Grand Rapids, MI 49505-5525 | 2020-08-17 |
| 1124644596 | Travis James Atkinson | Counselor | 3000 Wausaukee Dr Ne, Grand Rapids, MI 49525-1916 | 2020-06-22 |
| 1639790207 | Tracey Wicks | Counselor | 78 Centerbrook St Se, Grand Rapids, MI 49548-6902 | 2020-05-05 |
| 1174160592 | Lindsey Elizabeth Rosa | Counselor | 845 5th St Nw Apt 2, Grand Rapids, MI 49504-5163 | 2019-12-04 |
| 1710530597 | New Way Counseling LLC | Counselor | 1971 E Beltline Ave Ne Ste C, Grand Rapids, MI 49525-7045 | 2019-07-19 |
| 1588216048 | Kate Jack | Counselor | 3351 Claystone St Se Ste G32, Grand Rapids, MI 49546-5794 | 2019-07-15 |
| 1104488105 | Travis Gordon | Counselor | 800 Monroe Ave Nw Ste 319, Grand Rapids, MI 49503-1451 | 2019-07-01 |
| 1255996575 | The Family Therapy Place Pllc | Counselor | 731 Front Ave Nw, Grand Rapids, MI 49504-5366 | 2019-05-02 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49548 |
Please comment or provide details below to improve the information on PINE REST CHRISTIAN MENTAL HEALTH SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.